MEDICARE: DANA LYNN LAMBROSE NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	201508192NP-PP	OR
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	NPF 21628	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649545328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA LYNN LAMBROSE NP

Provider Business Mailing Address
First Line	:	9801 OLYMPIC DR
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92646-4848
Country	:	US
Telephone Number	:	714-661-9032
Fax Number	:

Provider Business Practice Location Address
First Line	:	1055 WILSHIRE BLVD STE 1705
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90017-5600
Country	:	US
Telephone Number	:	714-661-9032
Fax Number	:	714-963-7302

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2012
Last Update Date	:	09/11/2020

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Directions to “ DANA LYNN LAMBROSE NP” Practice Location

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